oru.sePublikationer
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Phenotypic and genetic characterization of the first two cases of extended-spectrum-cephalosporin-resistant Neisseria gonorrhoeae infection in South Africa and association with cefixime treatment failure
Natl Inst Communicable Dis, Ctr HIV & Sexually Transmitted Infect, Natl Hlth Lab Serv, ZA-2192 Johannesburg, South Africa.;Univ Witwatersrand, Dept Internal Med, Fac Hlth Sci, ZA-2193 Pk Town, South Africa.;Univ Cape Town, Sch Med, Div Med Microbiol, ZA-7925 Observatory, South Africa..
Ampath Natl Lab Serv, Dept Clin Microbiol, ZA-0157 Centurion, South Africa..
Natl Inst Communicable Dis, Ctr HIV & Sexually Transmitted Infect, Natl Hlth Lab Serv, ZA-2192 Johannesburg, South Africa..
Orebro Univ Hosp, Dept Lab Med, Swedish Reference Lab Pathogen Neisseria, WHO Collaborating Ctr Gonorrhoea & Other STIs, SE-70185 Orebro, Sweden..
Show others and affiliations
2013 (English)In: Journal of Antimicrobial Chemotherapy, ISSN 0305-7453, E-ISSN 1460-2091, Vol. 68, no 6, 1267-1270 p.Article in journal (Refereed) Published
Abstract [en]

To describe the phenotypic and genetic characteristics of the first two cases of extended-spectrum cephalosporin (ESC)-resistant Neisseria gonorrhoeae in South Africa, one of which was associated with verified cefixime treatment failure. Two ESC-resistant N. gonorrhoeae isolates were cultured from the urethral discharge of two men who have sex with men (MSM). One man reported a persistent urethral discharge that had failed to respond to previous therapy with oral cefixime. Agar dilution MICs were determined for eight antibiotics. -Lactam-associated resistance mutations were identified through PCR-based amplification and sequencing for several key genes: penA, mtrR and its promoter, porB1b (penB), ponA and pilQ. For molecular epidemiological characterization, full-length porB gene sequencing, N. gonorrhoeae multiantigen sequence typing (NG-MAST) and multilocus sequence typing (MLST) were performed. Both isolates were resistant to cefixime, ciprofloxacin, penicillin and tetracycline and intermediate/resistant to azithromycin, but susceptible to ceftriaxone, gentamicin and spectinomycin. Both isolates had the type XXXIV penA mosaic allele in addition to previously described resistance mutations in the mtrR promoter (A deletion), porB1b (penB) (G101K and A102N) and ponA1 (L421P). Both isolates had an identical NG-MAST sequence type (ST4822) and MLST sequence type (ST1901). Both isolates were resistant to cefixime and possessed a number of identical mutations in key genes contributing to ESC resistance in N. gonorrhoeae. The two isolates contained the type XXXIV penA mosaic allele and belonged to a successful international MSM-linked multidrug-resistant gonococcal clone (MLST ST1901) associated with several cefixime treatment failures in Europe and North America.

Place, publisher, year, edition, pages
2013. Vol. 68, no 6, 1267-1270 p.
Keyword [en]
gonorrhoea, mosaic penA genes, cefpodoxime, ceftriaxone
National Category
Infectious Medicine Pharmacology and Toxicology Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-56603DOI: 10.1093/jac/dkt034ISI: 000319468900008PubMedID: 23416957OAI: oai:DiVA.org:oru-56603DiVA: diva2:1083225
Available from: 2017-03-20 Created: 2017-03-20 Last updated: 2017-03-20Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Unemo, Magnus
By organisation
Orebro University Hospital
In the same journal
Journal of Antimicrobial Chemotherapy
Infectious MedicinePharmacology and ToxicologyMicrobiology in the medical area

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 7 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf